Checking In at M.D. Anderson

Pre-Op Visit

Our first stop was not until 9:30am, and that was a pre-op visit with the primary surgeon, Dr. Yu. He built my new jaw, out of titanium and a chunk of my fibula from my left leg, and he knew where the blood supply lines were going, so he was the one to do the initial surgery.

The plan was to thin down the "bulk" they added to to build an artificial gum line over the new jawbone they built. Then they planned on drilling into the bone and attaching several metal posts they will eventually use to screw on a new dental plate with teeth. Once Dr. Yu was finished up, Dr. Hoffstead, my dentist from the Head and Neck area, would put in the posts. Then they would sew everything back up and let it heal for several months before working on the new dental plate.

Dr. Yu also planned on doing some liposuction to transfer some fat from my stomach (what fat? I are skinny these days!). He plans on pasting that fat into the area on the side of my face where they took out a lot of bone over two surgeries. The hope is that after several of these procedures, they can restore some of my face, and it will not look so scary!

We went over the procedure, and I signed away my life as usual. Our favorite PA, Brooke, a nice lady from Nebraska, went over all of the possible side effects with us. After hearing all of that, we thought about running screaming from the room, but decided it was going to be OK, and signed on the dotted line. (Some of those side effects are downright silly, but they have to let you know anyway. You really do have choices here!)

Vampire Feeding Time

For some strange reasons, the vampire feeding time was noon this time. I thought all those critters were asleep at noon. Normally we feed them in the dark. I decided that the people stealing the blood were just helpers, the actual vampires were hanging around in some dark conference room somewhere. Anyway, the assistant was pretty good with that rusty 10-penny nail and this went smoothly.

We even got done in time for some lunch before my next stop.

Well, my companions had lunch. I was not allowed to eat since I was scheduled for a CT scan in a few hours. I had a juice while they ate real food.

CT Scan

This is getting pretty routine. The waiting area was vert crowded, never a good sign in this place. They called me back to get the IV started, and I discussed my issues with that with the nurse. She assured me that the IV would be right, or she would not let me go. After she got it going, she pushed some saline through the tube and it seemed fine.

I had to sit with that thing in my arm for another 45 minutes before my scan time came up, then it was back to the same small room I sat in on my last trip for another hour of sitting. This wait had a nice warm blanket at least. They never seem to pay the heat bill around this place. It is always cold!

The CT scan went normally, until that blasted "contrast" was pumped into my IV. Once again, the pressure seeded very intense and pain shot up my arm. Not quite as bad as the previous incident where I wanted to get them to stop, but bad enough. If the IV was in right, I suspect the pressure they are using is too high, at least for me. The pain only lasted about a minute, then the warm rush settled in and the rest of the scan went smoothly.

Following this procedure, we checked into the Rotary House, a hotel attached to the hospital for our two night stay. That lets Cheryl walk to the hospital if needed while I go through the surgery process. The room was very nice, much nicer than La Quinta, and about the same price. However, getting into this place is tricky, since it is always full.

Then we were done for the day.

Apple Store

When I went to bed last night, I could not the charging plug to go all the way into my iPhone, so we decided to stop at an Apple Store near our La Quinta to see if we could get it fixed. Fortunately, there was some junk, probably from my pocket, stuck in the plug and the tech was able to unstick it with a magic tool he had around his neck (I bet this happens a lot). He also used a can of air to blow things clean as well. That was great!

Dinner with Friends

As is becoming our tradition, we next headed up to Humble in north Houston to go to dinner with Cheryl's classmate, Sharon and her husband, Dan. Oh, yeah! We also got to visit with Little Bits, who was just as wired as before. She recognized me right away and was my best friend immediately.

We were off to dinner, planned for the Olive Garden, but that did not go as planned. We had a short wait before the waitress took us to our table. There were five grown adults in our group, and they put us at a table barely big enough for four. She started to pull up an extra chair on the side and cousin Bill asked if they could just pull two tables together to make room. They balked at that and told us we would have to wait for another table (there were four empty tables in a row at the time). After walking us back to the front of the room, we decided we did not want another table, we wanted another restaurant, one that actually had a clue about how to seat guests and we left and drove across the street to Outback Steakhouse. The table, and meal, was just fine there!

Rotary House

We got back to the hotel fairly early. We had a call from the hospital telling us to report to the surgical waiting area by 8:30 the next morning, with surgery planned for 9:30, so we managed to get a good night's sleep. Cousin Bill stayed at the La Quinta, since we could not get another room at the Rotary house.

Next morning, we got up, dressed, and walked to the Starbucks so Cheryl could get some coffee. Then we trekked across the hospital to the only elevator that stops on the fifth floor where surgery happens. We got to the waiting area and did just that. Waited for quite some time, well past the scheduled surgery time.

Sitting there we got to people watch, and some there made me glad I am doing as well as I am. There was one poor kid whose entire lower lip was undergoing some kind of reconstruction, and it did not look very well yet. Based on what I have seen there, that should be getting fixed soon, and I suspect that was why he was there. (M.D. Anderson has a great plastic surgery and prosthetics department!)

After sitting for a couple of hours, I got taken into a small recovery room and they started prepping me for the surgery. A nurse put the IV in the right way, with a "bee-sting" numbing shot before putting the real thing in the back of my hand. I do not know why, but the IV bothers me more than the surgery!

At around 11:30 they came and wheeled me down the hall to the surgical area. Cheryl and Bill went back to the waiting area.

Surgery Time

For all of my previous surgeries, I have been out before I hit the operating room. This time, I was in the room watching the preparations. They rolled the bed up against a really skinny table, then slid me over to that. It was cold, shoot, everything is cold here!

They did cover me up with a blanket, then put a big plastic tube under the blanket that they said would have warm air pumped through it. The real reason they keep things cold is to control germs. They really do not like the cold!

I say Dr. Yu's PA, Brooke was there, and I suspect I saw Dr. Yu, but he was in scrubs and I could not really see his face. Then the anesthetist walked in and started having me breathe through a mask.

La La Land

That was all I remembered about the surgery. Apparently, it wend very well. Dr. Yu did his magic on my gum line, debulking it, and also did the fat transfer work. He used a needle to pull fat from a small hole in my stomach and injected it back in thin layers around my face. Not too much this time, but enough to tell a difference.

Following Dr. Yu, Dr Hoffstead came in and put the posts in my jawbone,

Hospitals are paranoid about doing things in the wrong place. They mark you up with a pen telling everyone where things will happen, and they put a wrist band on me saying the same thing. Except mine said:

Dental posts in left fibula

Then on the next line it said:

/mandible

When I first read that I imagined they were going to put the posts in my leg. Of course, the fibula they were talking about was transplanted into my mouth on my last surgery. Phew!

When I woke up from surgery, Dr. Hoffstead was standing there, and I asked her if she was happy with the results. She said she was, then they whisked me off to a recovery room.

Recovery

I could feel some puffiness in my face, but no pain. Cheryl was waiting for me in the room and said "You look great". She could tell they had filled part of my face in just fine. The posts in my mouth are not visible, since they put sutures in over them until things heal. They did make a small incision in my chin to remove four screws from the titanium strap, which would get in the way of the dental plate that comes next.

This was supposed to be "out-patient" surgery, meaning they might have booted me out of the hospital as soon as I woke up. However, the plan was to keep me over night and make sure everything was fine before releasing me on Friday morning.

So, I moved from the recovery area to the 11th floor area where i had a nice corner room with a view of the old Houston Astrodome. I spent the night there, with Cheryl and Bill visiting until it was time for them to go to dinner. Cheryl came back for a while, then she walked off to her room and I managed to get some sleep. As usual, I got awakened every four hours to check "vitals", but things went smoothly.

CT Results

The next morning, after Cheryl got to the room, we found out that a message had been left on my phone. Cheryl was keeping that, so we did not notice it. The message was from Dr. Garcia, Dr Lai's PA, who said the CT scan looked clean, and the "enhancement" they saw last time, was smaller this time and not a concern. Great! Another ticket punched.

We were supposed to get a visit from Dr. Yu's PA around 7AM, but Brooke did not appear until around noon. More surgery that morning went longer than planned. She gave me a look over and declared me ready to go home.

As usual, it took over an hour to get the paperwork done, and more time waiting for the required wheelchair ride to the lobby. We escaped around 3:00pm.

Microcenter, then Home

I needed a few parts for my class lab projects, so I made a quick stop at Microcenter on the way out of town, then we were off for home. The drive went well, even though we ended up back in Austin at the end of rush hour. That was a bit worse than usual, since Spring Break is this week, and SXSW starts up this weekend.

Great Trip

All in all, this was a great trip. We had a clean CT scan, and the dental surgery went well. I get to heal for about four months, then do this entire process over again. This time, after the CT scan, they will be adding new teeth. We all hope thta works and my eating improves.

I am pretty tired from all of this, and wanted to do nothing but sleep all day Saturday. Cheryl and I were going to go to KC for the break, but we decided that would be too much for me this soon after surgery. So she left this morning and will be in KC for a week working on our house there and visiting with grandson, Colin and his family! Life is almost back to normal.

Just they way we like it!